Topical Treatments for Chronic Hives

The red, itchy welts caused by chronic hives can interfere with day-to-day life. Most people find relief with oral antihistamines and other drugs. However, some people turn to skin creams to ease the symptoms of chronic hives.^1,2

Can skin creams be used to treat chronic hives?

Experts do not recommend regularly using skin creams to treat chronic hives. They are usually not effective and do not improve symptoms long-term. Skin creams with steroids or antihistamines can also cause side effects.^1,2

Some lotions may temporarily relieve itching. Calamine lotions and creams that contain menthol or pramoxine may soothe the skin. They usually do not cause side effects. But long-term use will not be effective in treating symptoms of chronic hives.^1,3

Steroid skin creams

Skin creams that contain steroids are called topical steroids or topical corticosteroids. They work by constricting blood vessels in your skin. This reduces inflammation and reduces rashes, itchiness, and swelling.⁴

Topical steroids can be prescribed by your doctor or purchased over the counter (OTC). They are divided into 7 classes based on their strength. Class 1 contains the strongest steroids, and Class 7 contains the weakest steroids. An example of Class 7 would be the OTC versions of hydrocortisone 1 percent.⁵

Talk to your doctor before using topical steroids. They may first try to use other treatment methods, such as antihistamines. If you decide to try topical steroids, your doctor can suggest the right strength for you and advise you on the duration of treatment. Follow this direction closely to avoid side effects.^6,7

Stronger topical steroids have a higher risk of side effects. Common side effects of topical steroids include:¹

• Skin thinning (dermal atrophy)
• Bruising
• Large blood vessels
• Thickening of hair
• Stretch marks
• Burning or stinging

These are not all the possible side effects of topical steroids. Talk to your doctor about what to expect when taking these drugs. You also should call your doctor if you have any changes that concern you when taking topical steroids.

Some studies show that topical steroids do not reduce symptoms in chronic hives, so your doctor may suggest you avoid these products. They may prescribe oral steroids instead.^1,2

Antihistamine skin cream

Doxepin (Zonalon®) is an antidepressant and antihistamine. When used in cream form, it can help reduce itching. It is most often used to reduce itchiness for adults with eczema. It should only be used for a short period of time (less than a week).^7,8

Talk to your doctor before using doxepin cream. It may not be beneficial in the long term for people with chronic hives. It can also cause side effects, including:⁹

• Drowsiness
• Confusion
• Dizziness
• Allergic reactions

Because of this, your doctor may suggest other treatments to try to manage your symptoms.

These are not all the possible side effects of doxepin cream. Talk to your doctor about what to expect when taking this drug. You also should call your doctor if you have any changes that concern you when taking doxepin cream.

Other skin lotions

There are some steroid-free and antihistamine-free lotion options. These anti-itch lotions can help relieve itching and soothe your skin. They have very few side effects. However, they are only slightly effective for people with chronic hives. Examples include:^1,3

• Calamine lotions
• Lotions with colloidal oatmeal
• Lotions with menthol and camphor
• Lotions with pramoxine

Talk to your doctor before trying any OTC skin lotions. They might recommend a topical regimen that could give you temporary relief when your hives flare.